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ResumenMacrosiphonia petraea crece sobre suelos franco-arenosos, es perenne y sus flores blancas son vespertinas. En un ensayo en macetas bajo invernáculo en Buenos Aires se evaluó el comportamiento en dichas condiciones, la existencia de polimorfismos y se identificó a los individuos atractivos. Los caracteres considerados fueron números de tallos, de flores y de días desde la siembra hasta la aparición de la primera flor de cada planta. También se midió la longitud de los tallos y se estimó la extensión del período de floración. Se halló que la floración se concentró en verano con picos en enero y en febrero y se identificaron individuos de tallos péndulos o erectos. El número de tallos fue un carácter importante para la calidad subjetivamente determinada siendo más atractivos los individuos compactos, con un mayor número de tallos. Las plantas mostraron susceptibilidad a plagas insectiles, manteniendo la turgencia aún con temperaturas altas. Se concluyó que existen polimorfismos para los caracteres observados y que por su rusticidad M. petraea podría posicionarse como una opción decorativa de bajo mantenimiento en nichos comerciales tales como jardines de roca en lugares con actividad nocturna. La selección, un programa de fertilización comercial y un manejoen exterior a partir del inicio de la época cálida, probablemente permitirían obtener un número superior flores y mejor estado sanitario.AbstractMacrosiphonia petraea grows on sandy loam soils, is perennial and its white flowers are vespertine. In a greenhouse test in pots carried out in Buenos Aires, behaviour in those conditions was evaluated, the existence of polymorphisms and attractive individuals were identified. Features considered were number of stalks, number of flowers and days since planting up to appearance of first flower in each plant. Length of stalks was also measured and length of flowering period was estimated. Flowering concentrated during summer with peaks in January and February and individuals with pendant or erect stalks were identified. Number of stalks was an important feature for the subjectively determined quality. Compact individuals with larger number of stalks being more attractive. Plants showed susceptibility to insect pests, and remained turgent even with high temperatures. Conclusion is that polymorphisms exist in the features observed and due to its rusticity M. petraea could be positioned as a low maintenance cost decorative option in commercial niches such as rock gardens, in nocturnal activity sites. Selection, a commercial fertilization program and outdoor management at the beginning of the warm season, would probably permit obtaining higher number of flowers and better sanitary condition.

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Purpose: This umbrella systematic review (SR) of SRs and meta-analysis seeks to comprehensively synthesize existing literature to identify and consolidate the diverse range of risk factors contributing to running-related injuries (RRIs)., Methods: Systematic searches were conducted on June 28, 2023, across Web of Science, SPORTDiscus, Scopus, PubMed, and Cochrane Library. We included SRs, whether accompanied by meta-analyses or not, that focused on investigating risk factors for RRIs within observational studies. The methodological quality of the SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews II. To assess the extent of overlap across reviews, the corrected covered area metric was calculated., Results: From 1509 records retrieved, 13 SRs were included. The degree of overlap between SRs was low (4%), and quality varied from critically low (n = 8) to low (n = 5). Two hundred seven outcomes assessed in 148 primary studies were identified as being associated with the occurrence of RRIs. The effect sizes of the associations for which risk measures were reported (n = 131) were classified as large (n = 30, 23%), medium (n = 38, 29%), small (n = 48, 37%) or no effect (n = 15, 11%). Running/training characteristics, health and lifestyle factors, along with morphological and biomechanical aspects, exhibit large effect sizes in increasing the risk for RRIs., Conclusion: Drawing from the outcomes of the low-quality SRs and associations with large effect sizes, our findings indicate that running/training characteristics and health and lifestyle factors, as well as morphological and biomechanical aspects, are all implicated in elevating the risk of RRIs, emphasizing the multifactorial basis of injury incidence in running. Given the low quality and heterogeneity of SR, individual findings warrant cautious interpretation., (Copyright © 2024. Production and hosting by Elsevier B.V.)

Background: Carbapenemase-producing Citrobacter freundii has been reported as a leading cause of healthcare-associated infections. Particularly, C. freundii belonging to the sequence type (ST) 18 is considered to be an emerging nosocomial clone., Objectives: To report the genomic background and phylogenomic analysis of a multidrug-resistant NDM-1-producing C. freundii ST18 (strain CF135931) isolated from an endangered green sea turtle affected by plastic pollution in Brazil., Methods: Genomic DNA was extracted and sequenced using the Illumina NextSeq platform. De novo assembly was performed by CLC Workbench, and in silico analysis accomplished by bioinformatics tools. For phylogenomic analysis, publicly available C. freundii (txid:546) genome assemblies were retrieved from the NCBI database., Results: The genome size was calculated at 5 290 351 bp, comprising 5263 total genes, 4 rRNAs, 77 tRNAs, 11ncRNAs, and 176 pseudogenes. The strain belonged to C. freundii ST18, whereas resistome analysis predicted genes encoding resistance to β-lactams (bla NDM-1 , bla OXA-1 , bla CMY-117 , and bla TEM-1C ), aminoglycosides (aph(3'')-Ib, aadA16, aph(3')-VI, aac(6')-Ib-cr, and aph(6)-Id), quinolones (aac(6')-Ib-cr), macrolides (mph(A) and erm(B)), sulphonamides (sul1 and sul2), tetracyclines (tetA and tetD), and trimethoprim (dfrA27). The phylogenomic analysis revealed that CF135931 strain is closely related to international human-associated ST18 clones producing NDM-1., Conclusion: Genomic surveillance efforts are necessary for robust monitoring of the emergence of drug-resistant strains and WHO critical priority pathogens within a One Health framework. In this regard, this draft genome and associated data can improve understanding of dissemination dynamics of nosocomial clones of carbapenemase-producing C. freundii beyond hospital walls. In fact, the emergence of NDM-1-producing C. freundii of global ST18 in wildlife deserves considerable attention., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Given the recently proposed three-filament theory of muscle contraction, we present a low-cost physical sarcomere model aimed at illustrating the role of titin in the production of active force in skeletal muscle. With inexpensive materials, it is possible to illustrate actin-myosin cross-bridge interactions between the thick and thin filaments and demonstrate the two different mechanisms by which titin is thought to contribute to active and passive muscle force. Specifically, the model illustrates how titin, a molecule with springlike properties, may increase its stiffness by binding free calcium upon muscle activation and reducing its extensible length by attaching itself to actin, resulting in the greater force-generating capacity after an active than a passive elongation that has been observed experimentally. The model is simple to build and manipulate, and demonstration to high school students was shown to result in positive perception and improved understanding of the otherwise complex titin-related mechanisms of force production in skeletal and cardiac muscles. NEW & NOTEWORTHY Our physical sarcomere model illustrates not only the classic view of muscle contraction, the sliding filament and cross-bridge theories, but also the newly discovered role of titin in force regulation, called the three-filament theory. The model allows for easy visualization of the role of titin in muscle contraction and aids in explaining complex muscle properties that are not captured by the traditional cross-bridge theory.

Two novel variants of Klebsiella pneumoniae carbapenemase (KPC) associated with resistance to ceftazidime-avibactam (CZA) and designated as KPC-113 and KPC-114 by NCBI were identified in 2020, in clinical isolates of Klebsiella pneumoniae in Brazil. While K. pneumoniae of ST16 harbored the bla KPC-113 variant on an IncFII-IncFIB plasmid, K. pneumoniae of ST11 carried the bla KPC-114 variant on an IncN plasmid. Both isolates displayed resistance to broad-spectrum cephalosporins, β-lactam inhibitors, and ertapenem and doripenem, whereas K. pneumoniae producing KPC-114 showed susceptibility to imipenem and meropenem. Whole-genome sequencing and in silico analysis revealed that KPC-113 presented a Gly insertion between Ambler positions 264 and 265 (R264_A265insG), whereas KPC-114 displayed two amino acid insertions (Ser-Ser) between Ambler positions 181 and 182 (S181_P182insSS) in KPC-2, responsible for CZA resistance profiles. Our results confirm the emergence of novel KPC variants associated with resistance to CZA in international clones of K. pneumoniae circulating in South America. IMPORTANCE KPC-2 carbapenemases are endemic in Latin America. In this regard, in 2018, ceftazidime-avibactam (CZA) was authorized for clinical use in Brazil due to its significant activity against KPC-2 producers. In recent years, reports of resistance to CZA have increased in this country, limiting its clinical application. In this study, we report the emergence of two novel KPC-2 variants, named KPC-113 and KPC-114, associated with CZA resistance in Klebsiella pneumoniae strains belonging to high-risk clones ST11 and ST16. Our finding suggests that novel mutations in KPC-2 are increasing in South America, which is a critical issue deserving active surveillance.

The spread of carbapenemase-producing Klebsiella pneumoniae beyond hospital settings is a global critical issue within a public health and One Health perspective. Another worrisome concern is the convergence of virulence and resistance in healthcare-associated lineages of K. pneumoniae leading to unfavorable clinical outcomes. During a surveillance study of WHO critical priority pathogens circulating in an impacted urban river in São Paulo, Brazil, we isolate two hypermucoviscous and multidrug-resistant K. pneumoniae strains (PINH-4250 and PINH-4900) from two different locations near to medical centers. Genomic investigation revealed that both strains belonged to the global high-risk sequence type (ST) ST11, carrying the bla KPC-2 carbapenemase gene, besides other medically important antimicrobial resistance determinants. A broad virulome was predicted and associated with hypervirulent behavior in the Galleria mellonella infection model. Comparative phylogenomic analysis of PINH-4250 and PINH-4900 along to an international collection of publicly available genomes of K. pneumoniae ST11 revealed that both environmental strains were closely related to hospital-associated K. pneumoniae strains recovered from clinical samples between 2006 and 2018, in São Paulo city. Our findings support that healthcare-associated KPC-2-positive K. pneumoniae of ST11 clone has successfully expanded beyond hospital settings. In summary, aquatic environments can become potential sources of international clones of K. pneumoniae displaying carbapenem resistance and hypervirulent behaviors, which is a critical issue within a One Health perspective., Competing Interests: All authors declare no conflicts of interest., (© 2023 The Authors. Published by Elsevier B.V.)

Wild birds have emerged as novel reservoirs and potential spreaders of antibiotic-resistant priority pathogens, being proposed as sentinels of anthropogenic activities related to the use of antimicrobial compounds. The aim of this study was to investigate the occurrence and genomic features of extended-spectrum β-lactamase (ESBL)-producing bacteria in wild birds in South America. In this regard, we have identified two ESBL (CTX-M-55 and CTX-M-65)-positive Escherichia coli (UNB7 and GP188 strains) colonizing Creamy-bellied Thrush ( Turdus amaurochalinus ) and Variable Hawk ( Geranoaetus polyosoma ) inhabiting synanthropic and wildlife environments from Brazil and Chile, respectively. Whole-genome sequence (WGS) analysis revealed that E. coli UNB7 and GP188 belonged to the globally disseminated clone ST602, carrying a wide resistome against antibiotics (β-lactams), heavy metals (arsenic, copper, mercury), disinfectants (quaternary ammonium compounds), and pesticides (glyphosate). Additionally, E. coli UNB7 and GP188 strains harbored virulence genes encoding hemolysin E, type II and III secretion systems, increased serum survival, adhesins and siderophores. SNP-based phylogenomic analysis, using an international genome database, revealed genomic relatedness (19-363 SNP differences) of GP188 with livestock and poultry strains, and genomic relatedness (61-318 differences) of UNB7 with environmental, human and livestock strains (Table S1), whereas phylogeographical analysis confirmed successful expansion of ST602 as a global clone of One Health concern. In summary, our results support that ESBL-producing E. coli ST602 harboring a wide resistome and virulome have begun colonizing wild birds in South America, highlighting a potential new reservoir of critical priority pathogens., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 The Authors. Published by Elsevier B.V.)

Objectives: The aim of this study was to perform a genomic investigation of a multiple fluoroquinolone-resistant Leclercia adecarboxylata strain isolated from a synanthropic pigeon in São Paulo, Brazil., Methods: Whole-genome sequencing was performed using an Illumina platform, and in silico deep analyses of the resistome were performed. Comparative phylogenomics was conducted using a global collection of publicly available genomes of L. adecarboxylata strains isolated from human and animal hosts., Results: L. adecarboxylata strain P62P1 displayed resistance to human (norfloxacin, ofloxacin, ciprofloxacin, and levofloxacin) and veterinary (enrofloxacin) fluoroquinolones. This multiple quinolone-resistant profile was associated with mutations in the gyrA (S83I) and parC (S80I) genes and the presence of the qnrS gene within an ISKpn19-orf-qnrS1-ΔIS3-bla LAP-2 module, previously identified in L. adecarboxylata strains isolated from pig feed and faeces in China. Genes associated with arsenic, silver, copper, and mercury resistance were also predicted. Phylogenomic analysis revealed clustering (378-496 single nucleotide polymorphism differences) with two L. adecarboxylata strains isolated from human and fish sources in China and Portugal, respectively., Conclusions: L. adecarboxylata is a Gram-negative bacterium of the Enterobacterales order and is considered an emergent opportunistic pathogen. Since L. adecarboxylata has adapted to human and animal hosts, genomic surveillance is highly recommended, in order to identify the emergence and spread of resistant lineages and high-risk clones. In this regard, this study provides genomic data that can help clarify the role of synanthropic animals in the dissemination of clinically relevant L. adecarboxylata within a One Health context., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

WHO priority pathogens have disseminated beyond hospital settings and are now being detected in urban and wild animals worldwide. In this regard, synanthropic animals such as urban pigeons ( Columba livia ) and rodents ( Rattus rattus , Rattus norvegicus and Mus musculus ) are of interest to public health due to their role as reservoirs of pathogens that can cause severe diseases. These animals usually live in highly contaminated environments and have frequent interactions with humans, domestic animals, and food chain, becoming sentinels of anthropogenic activities. In this study, we report genomic data of Escherichia coli strains selected for ceftriaxone and ciprofloxacin resistance, isolated from pigeons and black rats. Genomic analysis revealed the occurrence of international clones belonging to ST10, ST155, ST224 and ST457, carrying a broad resistome to beta-lactams, aminoglycosides, trimethoprim/sulfamethoxazole, fluoroquinolones, tetracyclines and/or phenicols. SNP-based phylogenomic investigation confirmed clonal relatedness with high-risk lineages circulating at the human-animal-environmental interface globally. Our results confirm the dissemination of WHO priority CTX-M-positive E. coli in urban rodents and pigeons in Brazil, highlighting potential of these animals as infection sources and hotspot for dissemination of clinically relevant pathogens and their resistance genes, which is a critical issue within a One Health perspective., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2022 The Authors.)

Escherichia coli are gut commensal bacteria and opportunistic pathogens, and the emergence of antimicrobial resistance threatens the safety of the food chain. To know the E. coli strains circulating in the Brazilian poultry sector is important since the country corresponds to a significant chicken meat production. Thus, we analyzed 90 publicly genomes available in a database using web-based tools. Genomic analysis revealed that sul alleles were the most detected resistance genes, followed by aadA, bla CTX-M , and dfrA. Plasmids of the IncF family were important, followed by IncI1-Iα, Col-like, and p0111. Genes of specific metabolic pathways that contribute to virulence (terC and gad) were predominant, followed by sitA, traT, and iss. Additionally, pap, usp, vat, sfa/foc, ibeA, cnf1, eae, and sat were also predicted. In this regard, 11 E. coli were characterized as avian pathogenic E. coli and one as atypical enteropathogenic E. coli. Phylogenetic analysis confirmed the predominant occurrence of B1 but also A, D, B2, F, E, G, C, and Clade I phylogroups, whereas international clones ST38, ST73, ST117, ST155, and ST224 were predicted among 53 different sequence types identified. Serotypes O6:H1 and:H25 were prevalent, and fimH31 and fimH32 were the most representatives among the 36 FimH types detected. Finally, single nucleotide polymorphisms-based phylogenetic analysis confirmed high genomic diversity among E. coli strains. While international E. coli clones have adapted to the Brazilian poultry sector, the virulome background of these strains support a pathogenic potential to humans and animals, with lineages carrying resistance genes that can lead to hard-to-treat infections., (© 2022. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

Looped elastic bands around the thigh are commonly used during squats and result in increased hip activation. Due to the closed kinetic chain nature of the squat exercise, one may expect that placing the elastic band on distal segments, close to the floor contact, may not result in the same increase in hip muscle activation as that achieved with a looped band around the thigh. We analyzed the effects of band position (thigh, lower leg, and forefoot) and band stiffness on the myoelectric activity of the tensor fascia latae, gluteus medius, gluteus maximus, biceps femoris, vastus medialis, and vastus lateralis during squats in 35 healthy subjects (18 men and 17 women). The greatest myoelectric activity of hip muscles was observed when the stiffest band was positioned around the forefeet with an increase in 24% for the tensor fascia latae, 83% for the gluteus medius, and 68% for the gluteus maximus compared to free (without resistance band) squatting. Contrary to previous thinking, the use of elastic bands around the forefeet during squats can elicit increased myoelectric activity of hip muscles, with a magnitude often greater than when the band is placed around the thigh segments.

Extended spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae is a medically important pathogen that commonly causes human nosocomial infections. Since veterinary emergency and critical care services have also significantly progressed over the last decades, there are increasing reports of ESBL-producing K. pneumoniae causing hospital-associated infections in companion animals. We present microbiological and genomic analysis of a multidrug-resistant ESBL-positive K. pneumoniae (LCKp01) isolated from a fatal infection in a dog admitted to a veterinary intensive care unit. LCKp01 strain belonged to the sequence type ST392 and displays a KL27 (wzi-187) and O-locus 4 (O4). A broad resistome and presence of the bla CTX-M-15 ESBL gene were predicted. SNP-based phylogenomic analysis, using an international genome database, clustered LCKp01 (60-80 SNPs differences) with K. pneumoniae ST392 from human and animal infections, isolated at 4-year interval, whereas phylogeographical analysis confirmed successful expansion of ST392 as a global clone of One Health concern., Competing Interests: All authors declare no conflicts of interest., (© 2022 The Authors.)

Carbapenemase-producing Enterobacterales are rapidly spreading and adapting to different environments beyond hospital settings. During COVID-19 lockdown, a carbapenem-resistant NDM-1-positive Escherichia coli isolate (BA01 strain) was recovered from a pygmy sperm whale ( Kogia breviceps ), which was found stranded on the southern coast of Brazil. BA01 strain belonged to the global sequence type (ST) 162 and carried the bla NDM-1 , besides other medically important antimicrobial resistance genes. Additionally, genes associated with resistance to heavy metals, biocides, and glyphosate were also detected. Halophilic behavior (tolerance to > 10% NaCl) of BA01 strain was confirmed by tolerance tests of NaCl minimal inhibitory concentration, whereas halotolerance associated genes katE and nhaA /H + /H + antiporter cytoplasmic membrane, respectively, were in silico confirmed. Phylogenomics clustered BA01 with poultry- and human-associated ST162 lineages circulating in European and Asian countries. Important virulence genes, including the astA (a gene encoding an enterotoxin associated with human and animal infections) were detected, whereas in vivo experiments using the Galleria mellonella infection model confirmed the virulent behavior of the BA01 strain. WHO critical priority carbapenemase-producing pathogens in coastal water are an emerging threat that deserves the urgent need to assess the role of the aquatic environment in its global epidemiology., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Sellera, Cardoso, Fuentes-Castillo, Esposito, Sano, Fontana, Fuga, Goldberg, Seabra, Antonelli, Sandri, Kolesnikovas and Lincopan.)

The dissemination of carbapenem-resistant and third generation cephalosporin-resistant pathogens is a critical issue that is no longer restricted to hospital settings. The rapid spread of critical priority pathogens in Brazil is notably worrying, considering its continental dimension, the diversity of international trade, livestock production, and human travel. We conducted a nationwide genomic investigation under a One Health perspective that included Escherichia coli strains isolated from humans and nonhuman sources, over 45 years (1974-2019). One hundred sixty-seven genomes were analyzed extracting clinically relevant information (i.e., resistome, virulome, mobilome, sequence types [STs], and phylogenomic). The endemic status of extended-spectrum β-lactamase (ESBL)-positive strains carrying a wide diversity of bla CTX-M variants, and the growing number of colistin-resistant isolates carrying mcr -type genes was associated with the successful expansion of international ST10, ST38, ST115, ST131, ST354, ST410, ST648, ST517, and ST711 clones; phylogenetically related and shared between human and nonhuman hosts, and polluted aquatic environments. Otherwise, carbapenem-resistant ST48, ST90, ST155, ST167, ST224, ST349, ST457, ST648, ST707, ST744, ST774, and ST2509 clones from human host harbored bla KPC-2 and bla NDM-1 genes. A broad resistome to other clinically relevant antibiotics, hazardous heavy metals, disinfectants, and pesticides was further predicted. Wide virulome associated with invasion/adherence, exotoxin and siderophore production was related to phylogroup B2. The convergence of wide resistome and virulome has contributed to the persistence and rapid spread of international high-risk clones of critical priority E. coli at the human-animal-environmental interface, which must be considered a One Health challenge for a post-pandemic scenario. IMPORTANCE A One Health approach for antimicrobial resistance must integrate whole-genome sequencing surveillance data of critical priority pathogens from human, animal and environmental sources to track hot spots and routes of transmission and developing effective prevention and control strategies. As part of the Grand Challenges Explorations: New Approaches to Characterize the Global Burden of Antimicrobial Resistance Program, we present genomic data of WHO critical priority carbapenemase-resistant, ESBL-producing, and/or colistin-resistant Escherichia coli strains isolated from humans and nonhuman sources in Brazil, a country with continental proportions and high levels of antimicrobial resistance. The present study provided evidence of epidemiological and clinical interest, highlighting that the convergence of wide virulome and resistome has contributed to the persistence and rapid spread of international high-risk clones of E. coli at the human-animal-environmental interface, which must be considered a One Health threat that requires coordinated actions to reduce its incidence in humans and nonhuman hosts.

During a surveillance study conducted to assess the occurrence and genomic landscape of critical priority pathogens circulating at the human-animal-environment interface in Brazil, as part of the Grand Challenges Explorations-New Approaches to Characterize the Global Burden of Antimicrobial Resistance program, two multidrug-resistant (MDR) Citrobacter portucalensis carrying bla CTX-M-15 extended-spectrum β-lactamase (ESBL) genes, isolated from green sea turtles, were characterized. Genomic and phylogeographical analysis of C. portucalensis genomes available in public databases revealed the intercontinental dissemination of clades carrying different arrays of clinically relevant genes conferring resistance to carbapenems, broad-spectrum cephalosporins, cephamycins, aminoglycosides and fluoroquinolones, disinfectants, and heavy metals. Our observations suggest that C. portucalensis could be emerging as critical priority bacteria of both public and One Health importance worldwide. IMPORTANCE The global spread of antibiotic-resistant priority pathogens beyond the hospital setting is a critical issue within a One Health context that integrates the human-animal-environment interfaces. On the other hand, next-generation sequencing technologies along with user-friendly and high-quality bioinformatics tools have improved the identification of bacterial species, and bacterial resistance surveillance. The novel Citrobacter portucalensis species was proposed in 2017 after taxonomic reclassification and definition of the strain A60 T isolated in 2008. Here, we presented genomic data showing the occurrence of multidrug-resistant C. portucalensis isolates carrying bla CTX-M-15 ESBL genes in South America. Additionally, we observed the intercontinental dissemination of clades harboring a broad resistome to clinically relevant antibiotics. Therefore, these findings highlight that C. portucalensis is a global MDR bacteria that carries intrinsic bla CMY - and qnrB -type genes and has become a critical priority pathogen due to the acquisition of clinically relevant resistance determinants, such as ESBL and carbapenemase-encoding genes.

Background: Patellofemoral pain (PFP) is typically accompanied by changes in movement pattern. However, it is unclear if these changes persist in the remission phase of symptoms. Investigating movement patterns in individuals in remission phase of PFP may help to further guide the rehabilitation process and to understand whether changes are due to high levels of pain or related to other factors., Purpose: To compare 3D kinematics during walking and the single leg squat (SLS) between individuals with history of PFP in remission phase and a control group without history of lower limb injuries and PFP., Study Design: Cross-sectional case-control study., Methods: Individuals with onset of PFP for at least one year and in phase of remission of symptoms (experimental group [EG]; n=13, 30±8 years) were compared to a control group (CG, n=13, 28±7 years). A 10-camera motion analysis system (Vicon-Nexus®) was used to record 3D ankle, knee, hip and trunk angles during walking and SLS., Results: The EG presented less ankle dorsiflexion, knee and hip flexion during the stance phase of walking compared to the CG (p=0.005, large effect size ηp2 = 0.141). During the SLS, no between-group differences were observed for the ankle, knee and hip angles at the peak of knee flexion (p>0.05). A trend for increased trunk range of movement in the EG compared to the CG was observed (p=0.075, medium effect size ηp2 = 0.127)., Conclusion: The results of this study indicate less movement in the sagittal plane during walking, and a trend towards more movement of the trunk during SLS in the EG compared to the CG. The participants of the EG had minimal symptoms, to the point of not classifying them as pathological. However, the between-group differences suggest that even in the remission phase, kinematic differences persist for some reason and may contribute to the recurring pain in PFP individuals., Level of Evidence: Level 3., Competing Interests: The authors report no conflicts of interest or bias in this work.

The addition of manual pressure on the electrode during neuromuscular electrical stimulation (NMES) has been used to reduce current intensity and perceived discomfort. In this study we aimed to test i) whether this approach affect the reliability of commonly made torque output measurements and ii) whether subcutaneous-fat thickness influence the efficacy of this approach in reducing current intensity and perceived discomfort. Twenty-one men (24 ± 3.1 years) performed knee extension maximal voluntary isometric contractions with and without manual pressure on the NMES femoral nerve electrode (superimposed and resting doublets, 2 pulses at 100 Hz) during two separate sessions. Torque output was measured in an isokinetic dynamometer and thigh subcutaneous-fat thickness assessed with ultrasonography. A scale of perceived discomfort was presented after contractions. Reductions in current intensity ( ) and discomfort during superimposed doublet ( p=0.002 ) and resting doublet ( p=0.002 ) were confirmed for the condition in which pressure was applied to the electrode. Fat thickness was correlated to changes in current intensity (r = 0.63; p = 0.002) and changes in discomfort (r = 0.45; p = 0.04) and no differences between pressure conditions and testing sessions were observed for torque output ( p > 0.05; ICC 0.95). Adding manual pressure during NMES on femoral nerve reduces discomfort and the maximal NMES intensity required to reach maximum torque without affecting torque output magnitude and reliability. Greater reduction in intensity and discomfort were observed in participants with higher subcutaneous-fat thickness levels after adding pressure on the electrode.

Convergence of resistance and virulence in Klebsiella pneumoniae is a critical public health issue worldwide. A multidrug-resistant CTX-M-15-producing K. pneumoniae (TIES-4900 strain) was isolated from a highly impacted urban river, in Brazil. The genome was sequenced by MiSeq Illumina platform and de novo assembled using Unicycler. In silico prediction was accomplished by bioinformatics tools. The size of the genome is 5.4 Mb with 5145 protein-coding genes. TIES-4900 strain belonged to the sequence type ST15, yersiniabactin sequence type YbST10, ICEKp4, KL24 (wzi-24) and O1v1 locus. Phylogenomics confirmed genomic relatedness with ST15 clones from human and animal hosts. Convergence of broad resistome (antibiotics, heavy-metals and biocides) and virulome, including the Kpi pilus system involved in host-pathogen interaction and persistence of ST15 clone to hospital environments, were predicted. Virulent behavior was confirmed in the Galleria mellonella infection model. This study may give genomic insights on the spread of critical-priority WHO pathogens beyond hospital settings., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

The dissemination of antibiotic-resistant priority pathogens beyond hospital settings is both a public health and an environmental problem. In this regard, high-risk clones exhibiting a multidrug-resistant (MDR) or extensively drug-resistant (XDR) phenotype have shown rapid adaptation at the human-animal-environment interface. In this study, we report genomic data and the virulence potential of the carbapenemase, São Paulo metallo-β-lactamase (SPM-1)-producing Pseudomonas aeruginosa strains (Pa19 and Pa151) isolated from polluted urban rivers, in Brazil. Bioinformatic analysis revealed a wide resistome to clinically relevant antibiotics (carbapenems, aminoglycosides, fosfomycin, sulfonamides, phenicols, and fluoroquinolones), biocides (quaternary ammonium compounds) and heavy metals (copper), whereas the presence of exotoxin A, alginate, quorum sensing, types II, III, and IV secretion systems, colicin, and pyocin encoding virulence genes was associated with a highly virulent behavior in the Galleria mellonella infection model. These results confirm the spread of healthcare-associated critical-priority P. aeruginosa belonging to the MDR sequence type 277 (ST277) clone beyond the hospital, highlighting that the presence of these pathogens in environmental water samples can have clinical implications for humans and other animals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer AB declared a shared affiliation with no collaboration with several of the authors FE, HF, BF, and NL to the handling editor at the time of the review., (Copyright © 2021 Esposito, Cardoso, Fontana, Fuga, Cardenas-Arias, Moura, Fuentes-Castillo and Lincopan.)

Introduction:  Venous thromboembolism (VTE) is the primary cause of preventable death in hospitalized patients in the United States. This is a cross-sectional study with a brief cost analysis of thromboprophylaxis with rivaroxaban and enoxaparin in acutely ill medical inpatients., Methods:  The study included a total of 122 patients admitted to a public teaching hospital from December 2019 to January 2021. The sample was equally divided into two groups according to the thromboprophylactic agent prescribed: rivaroxaban or enoxaparin. The primary outcomes included bleeding and symptomatic, ultrasonography-confirmed arterial or venous thrombotic events during or within 90 days after hospitalization. Our secondary outcome was the direct costs of each anticoagulant in US dollars over the 14 months., Results:  During hospitalization, two events were detected in the enoxaparin group: minor bleeding with minimum intervention required (1.6%) and a deep vein thrombosis (DVT) case (1.6%) confirmed by ultrasonography. Within 90 days after discharge, two patients, one of each sample (1.6% vs. 1.6%), were readmitted due to confirmed acute arterial occlusion. Concerning financial assessment, the mean unit cost of enoxaparin during the 14 months assessed was 102.14% more expensive than rivaroxaban., Conclusions:  Both rivaroxaban and enoxaparin showed equivalence in effectiveness and safety in thromboprophylaxis in medical inpatients, aside from possible financial benefit with the first-mentioned drug., Competing Interests: GM received personal fee from Bayer, Boehringer Ingelheim and Astrazeneca for consulting and speaker bureau. JG is executive director of Cajuru University Hospital., (Copyright © 2021, Lenci Marques et al.)

Objectives: The global success of carbapenem-resistant pathogens has been attributed to large plasmids carrying bla KPC genes circulating among high-risk clones. In this study, we sequenced the genome of a carbapenem-resistant Escherichia coli strain (Ec351) isolated from a human infection. Phylogenomic analysis based on single nucleotide polymorphisms (SNPs) as well as the comparative resistome and plasmidome of globally disseminated bla KPC-2 -positive E. coli strains with identical sequence type (ST) were further investigated., Methods: Total DNA was sequenced using an Illumina NextSeq 500 platform and was assembled using Unicycler. Genomic data were evaluated through bioinformatics tools available from the Center of Genomic Epidemiology and by in silico analysis., Results: Genomic analysis revealed the convergence of a wide resistome and virulome in E. coli ST648, showing a high-level phylogenetic relationship with a KPC-2-positive ST648 cluster identified in the USA and association with international clade 2. Additionally, the emergence of an IncQ1 small plasmid (pEc351) carrying bla KPC-2 (on an NTE KPC -IId element), aph(3')-VIa, and plasmid regulatory and replication genes in the pandemic clone ST648 is reported., Conclusion: Identification of a bla KPC-2 -positive IncQ1 plasmid in a high-risk E. coli clone represents rapid adaptation and expansion of these small plasmids encoding carbapenemases to novel bacterial hosts with global distribution, which deserves continued monitoring., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Klebsiella pneumoniae causes a diversity of infections in both healthcare and community settings. This pathogen is showing an increased ability to accumulate antimicrobial resistance and virulence genes, making it a public health concern. Here we describe the whole-genome sequence characteristics of an ST15 colistin-resistant K. pneumoniae isolate obtained from a blood culture of a 79-year-old female patient admitted to a university hospital in Brazil. Kp14U04 was resistant to most clinically useful antimicrobial agents, remaining susceptible only to aminoglycosides and fosfomycin. The colistin resistance in this isolate was due to a ~1.3 kb deletion containing four genes, namely mgrB , yebO , yobH and the transcriptional regulator kdgR . The study isolate presented a variety of antimicrobial resistance genes, including the carbapenemase-encoding gene bla KPC-2 , the extended-spectrum beta-lactamase (ESBL)-encoding gene bla SHV-28 and the beta-lactamase-encoding gene bla OXA-1 . Additionally, Kp14U04 harboured a multiple stress resistance protein, efflux systems and regulators, heavy metal resistance and virulence genes, plasmids, prophage-related sequences and genomic islands. These features revealed the high potential of this isolate to resist antimicrobial therapy, survive in adverse environments, cause infections and overcome host defence mechanisms.

The global spread of antibiotic-resistant bacteria and their resistance genes is a critical issue that is no longer restricted to hospital settings, but also represents a growing problem involving environmental and food safety. In this study, we have performed a microbiological and genomic investigation of critical priority pathogens resistant to broad-spectrum cephalosporins and showing endophytic lifestyles in fresh vegetables sold in a country with high endemicity of extended-spectrum β-lactamases (ESBLs). We report the isolation of international high-risk clones of CTX-M-15-producing Escherichia coli , belonging to clonal complexes CC38 and CC648, and Klebsiella pneumoniae of complex CC307 from macerated tissue of surface-sterilized leaves of spinach, cabbage, arugula, and lettuce. Regardless of species, all ESBL-positive isolates were able to endophytically colonize common bean ( Phaseolus vulgaris ) seedlings, showed resistance to acid pH, and had a multidrug-resistant (MDR) profile to clinically relevant antibiotics (i.e., broad-spectrum cephalosporins, aminoglycosides, and fluoroquinolones). Genomic analysis of CTX-M-producing endophytic Enterobacterales revealed a wide resistome (antibiotics, biocides, disinfectants, and pesticides) and virulome, and genes for endophytic fitness and for withstanding acidic conditions. Transferable IncFIB and IncHI2A plasmids carried bla CTX-M-15 genes and, additionally, an IncFIB plasmid (named pKP301cro) also harbored genes encoding resistance to heavy metals. These data support the hypothesis that fresh vegetables marketed for consumption can act as a figurative Trojan horse for the hidden spread of international clones of critical WHO priority pathogens producing ESBLs, and/or their resistance genes, to humans and other animals, which is a critical issue within a food safety and broader public and environmental health perspective. IMPORTANCE Extended-spectrum β-lactamases (ESBL)-producing Enterobacterales are a leading cause of human and animal infections, being classified as critical priority pathogens by the World Health Organization. Epidemiological studies have shown that spread of ESBL-producing bacteria is not a problem restricted to hospitals, but also represents a growing problem involving environmental and food safety. In this regard, CTX-M-type β-lactamases have become the most widely distributed and clinically relevant ESBLs worldwide. Here, we have investigated the occurrence and genomic features of ESBL-producing Enterobacterales in surface-sterilized fresh vegetables. We have uncovered that international high-risk clones of CTX-M-15-producing Escherichia coli and Klebsiella pneumoniae harboring a wide resistome and virulome, carry additional genes for endophytic fitness and resistance to acidic conditions. Furthermore, we have demonstrated that these CTX-M-15-positive isolates are able to endophytically colonize plant tissues. Therefore, we believe that fresh vegetables can act as a figurative Trojan horse for the hidden spread of critical priority pathogens exhibiting endophytic lifestyles., (Copyright © 2021 Lopes et al.)

Objectives: Klebsiella pneumoniae has emerged as one of the major pathogens of humans and companion animals. Moreover, polymyxin resistance in K. pneumoniae is increasingly reported worldwide, mainly among extended-spectrum β-lactamase (ESBL)- and/or carbapenemase-producing isolates. The aim of this study was to report the draft genome sequence of a polymyxin-resistant, ESBL-producing K. pneumoniae isolate (14CSI) from a hospitalised domestic cat in Brazil., Methods: Whole-genome sequencing of strain 14CSI was performed on an Illumina NextSeq platform and the genome was de novo assembled using Velvet v.1.2.10. Data analysis was performed using bioinformatics tools available from the Center for Genomic Epidemiology and the Institut Pasteur database., Results: The genome size of strain 14CSI was calculated at 5 260 459 bp, with a GC content of 57.3% and comprising 5294 total genes, 28 tRNAs, 7 rRNAs, 8 ncRNAs and 237 pseudogenes. Klebsiella pneumoniae strain 14CSI belongs to sequence type 491 (ST491), presents a mutation (A14S) in the mgrB gene and co-harbours bla CTX-M-8 and qnrE1 genes. Genes conferring resistance to heavy metals were further identified., Conclusion: This draft genome could be used as a reference sequence for comparative analysis of polymyxin-resistant and/or CTX-M-8-producing K. pneumoniae strains circulating at the human-animal interface., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Agonistic muscles lose approximately 20% of their individual torque-generating capacity when activated with their agonistic muscles compared with when stimulated in isolation. In this study, we (1) tested if this loss in torque was accompanied by a corresponding loss in force, thereby testing the potential role of changes in moment arms between conditions; (2) removed all inter-muscular connections between the quadriceps muscles, thus determining the potential role of inter-muscular force transmission; and (3) systematically changed the inter-muscular pressure by performing experiments at different activation/force levels, thereby exploring the possible role of inter-muscular pressure in the loss of torque capacity with simultaneous muscle activation. Experiments were performed in a New Zealand white rabbit quadriceps model ( N =5). Torque and force were measured during activation of femoral nerve branches that supply the individual quadriceps muscles while activating these branches simultaneously and in isolation. Regardless of joint angle and inter-muscular connections between muscles, the differences in torque values between the simultaneous and the isolated activation of the quadriceps muscles were also observed for the directly measured force values. Mean differences in simultaneous and isolated muscle activation remained similar between the intact and separated conditions: torque difference 21±5% of maximum isometric torque of intact condition (MIC torque ), versus 19±6% MIC torque , respectively, and force difference 18±3% MIC force versus 19±7% MIC force , respectively. The absolute torque loss was independent of the force, and thus presumably the inter-muscular pressures. Based on these results, we conclude that the torque deficit observed during simultaneous compared with isolated muscle activation is not primarily caused by moment arm, inter-muscular pressure or inter-muscular force transmission. The mechanisms underlying loss of force capacity during agonistic muscle contraction remain unknown., Competing Interests: Competing interestsThe authors declare no competing or financial interests., (© 2020. Published by The Company of Biologists Ltd.)

Many attempts have been made to determine the contribution of individual muscles in an agonistic group to the mechanics of joints. However, previous approaches had the limitations that muscles often could not be controlled in a precise manner, that individual muscles in an agonistic group could not be activated individually, and that individual muscle contributions could not be measured in an actively contracting agonistic group. Here, we introduce a surgical approach that allows for controlled activation of individual muscles of an agonistic group. The approach is illustrated for the vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) of the rabbit quadriceps femoris group. We provide exemplar results for potential applications of the approach, such as measuring the pressure distribution in the patellofemoral joint, and the torque-angle relationship of VL, VM and RF when activated individually and when the three muscles are activated simultaneously., Competing Interests: Competing interestsThe authors declare no competing or financial interests., (© 2019. Published by The Company of Biologists Ltd.)

We hereby present the 3.7-Mb draft genome sequence of Plesiomonas shigelloides strain FM82, isolated from a tilapia (Oreochromis niloticus) reared in a fish farm in Rio de Janeiro, Brazil. P. shigelloides strain FM82 carries antimicrobial resistance, biofilm, and CRISPR-related genes.

Background: The steady-state increase in muscle force generating potential following a lengthening contraction is called residual force enhancement (RFE). In this study, we aimed to test for differences in torque, electromyographic activity (EMG), and the associated neuromuscular efficiency (NME) between isometric voluntary contractions of elbow flexors preceded and not preceded by a lengthening contraction. The dependence of such differences on (i) stretch amplitude, (ii) the region of the force-length (FxL) relationship where contraction occurs, and (iii) the individual's ability to produce (negative) work during the stretch was investigated., Methods: Sixteen healthy adults participated in the study. Elbow flexor torque, angle, and biceps brachii EMG for purely isometric contractions (reference contractions) and for isometric contractions preceded by active stretches of 20° and 40° were measured at the ascending, plateau, and descending regions of subject-specific FxL curves. All contractions were performed in an isokinetic dynamometer. Two-factor (stretch × FxL region) repeated measures analysis of variance ANOVAs was used to analyze the effect of active stretch on EMG, torque, and NME across conditions. The relationships between mechanical work during stretch-calculated as the torque-angular displacement integral-and the changes in EMG, torque, and NME were analyzed using Pearson correlation., Results: In general, torque, EMG, and NME following active stretches differed from the values observed for the purely isometric reference contractions. While although the detailed effects of active stretch on torque and EMG differed between regions of the FxL relationship, NME increased by about 19% for all muscle lengths. Up to 30% of the interindividual variability in torque generating potential change in response to active stretching was accounted for by differences in (negative) work capacity between subjects., Conclusion: Our results suggest that (i) RFE contributes to "flatten" the elbow flexor torque-angle relationship, favoring torque production at lengths where the purely isometric torques are reduced substantially, and (ii) RFE contributes to a reduction in energy cost of torque production during isometric contractions for the entire operating range.